Prevalence of Dermatophytes and Non-Dermatophyte Fungal Infection among Patients Visiting Dermatology Clinic, at Tikur Anbessa Hospital, Addis Ababa, Ethiopia

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Addis Abeba University


Back ground: Dermatomycosis is a common fungal infection that constitutes public health problem among humans and animals worldwide, including Ethiopia. Though it is a trivial disease, its psychological effect and morbidity in terms of loss of time and treatment cost is considerable. Objective: To describe the most dominant clinical manifestation, the dominant fungi implicated as a cause of dermatomycosis and determine the prevalence of dermatophytes, non- dermatophyte fungi and yeasts collected from clinical samples suspected of dermatomycosis. Material and methods: a cross sectional descriptive study design from January to May, 2014 was conducted at Tikur Anbessa Hospital. Scrapings from skin nail and scalp of 305 study participants was collected by employing standard routine microbiological techniques. A portion of each sample was placed on a slide and a drop of an aqueous solution of 10% (w/v) potassium hydroxide, was added. After 5 minutes, the wet mount was examined under low (X10) and high (X40) power magnification for the presence of fungal elements. The remaining portion of each clinical sample was cultured irrespective of the negative or positive direct microscopic examination results. Each sample was streaked on two plates of Sabouraud’s dextrose agar (SDA) with chloramphenicol and SDA, with chloramphenicol and cychloheximide which were prepared according to the manufacture’s instruction. All inoculated plates were then incubated at inverted position for 4-6 weeks at 25-300C aerobically. Incubated plates were examined twice a week for any fungal growth. Colonies suspected of dermatophytes were sub-cultured into potato dextrose agar for the production of spores. Mold isolates were identified by examining macroscopic and microscopic characteristics of their colony. Microscopic identification of mold isolates was performed by placing pieces cultures from SDA and/or PDA to clean microscopic slide and staining with lactophenol cotton blue. After placing a cover slip, each preparation was observed microscopically. Yeast identification, C. albicans was differentiated from other yeasts by germ tube production. Data was analyzed using SPSS version 20 software. Result: A total of 305, study participants were enrolled in the present study of which 97 (31.8%) were males and 208 (68.2%) females. The ages of study subjects ranged from 1 to 80 year with a mean age of 26 years. Out of the 305 study subjects, fungal species were detected (direct microscopy) in 166 (54.4%) of clinical samples while 242(79.3%) clinical samples were culture positive. Sixteen clinical samples that were culture negative were positive by direct microscopy. The three predominant clinical manifestation were tinea ungium accounting 156(51.1%) of iv clinical manifestations of which 119 (76.3%) were in females and 37(23.7%) in males. This was followed by tinea capitis accounting 61 (20%) of which 37 (60.7%) in females and 24 (39.3%) in males followed tinea corporis accounting 33(10.8%) of which 26 (78.8%) in females and 7 (21.2 %) in males. Fungal species belong to dermatophyte; non-dermatophyte molds and yeasts were isolated and identified from 242 patients. Dermatophytes were isolated in 129 (53.3%) of culture positives followed by non-dermatophyte molds 60 (24.8%) and this was followed by yeast that accounted 53 (21.9%). Fungal groups that were predominant in clinical sites in descending order were dermatophyte, followed by non dermatophyte molds and the least were yeasts. Among dermatophytes T. violaceum and T.mentagrophyte were the dominant ones. Conclusion: The prevalence of fungi that cause different manifestation of dermatomycosis was high, which was 79.3%. Though dermatophytes were the predominat group the isolation rate of non-dermatophyte fungi and yeasts was also considerable indicating that the spectrums of fungi causing dermatomycosis are diverse.



Prevalence of Dermatophytes and Non-Dermatophyte Fungal Infection